Adult and Pediatric Rheumatology Fellowships

The mission of the Saint Louis University rheumatology fellowship training program
is to produce physicians that are clinically competent in the field of rheumatology,
are capable of working in a variety of settings and possess habits of lifelong learning
to build upon their knowledge, skills and professionalism.

Adult and Pediatric Rheumatology Training

The trainees who successfully complete this program will be fully trained and equipped
to function as clinical rheumatologists, clinician educators or clinician scientists,
depending on the individual career goals of the individuals. Our research is centered
on studies of Systemic Lupus Erythematosus on Regulatory T-cells, Systemic Lupus Erythematosus
on Interferon Signatures, Systemic Lupus Erythematosus on Syk and Immune Complexes,
Juvenile Idiopathic Arthritis on Isotypes of Anti-CCP Antibodies, and Rheumatoid Factors
and Glycosylation.

We are active participants in the Corrona Registry and CARRA (Childhood Arthritis
and Rheumatology Research Alliance) Network and have established an active clinical
trial program.

Our training program is one of the highest regarded nationally in both adult and pediatric
rheumatology by the American College of Rheumatology. Our fellowship program is accredited
for both Pediatric and Adult Rheumatology training through the American College of
Graduate Medical Education and our program is uniquely able to train fellows that
have completed either an internal medicine residency, medicine-pediatric residency
or pediatric residency.

Our Faculty

All of our faculty members are teaching faculty and work with fellows during clinics
and during consult rotations. We have a patient base of over 2,000 adults and over
1,200 children with rheumatic diseases. Our outpatient clinics are located at the
Saint Louis University Doctor’s Office Building, SLUCare Des Peres and SSM Health
Cardinal Glennon Children’s Hospital.

We have the largest children's arthritis center in St. Louis, the largest in the state
of Missouri and the eighth largest in the country. Our inpatient service is a consultation
service performed at both the SSM Health Saint Louis University Hospital and SSM Health
Cardinal Glennon Children's Hospital with about 200 consults per year.

Pediatric Program Strengths

The pediatric rheumatology fellowship at Saint Louis University Medical Center is
one of the oldest in the country. It is one of the original 12 accredited by the ACGME
in 1992. The Pediatric Clinic at SSM Health Cardinal Glennon Children’s Hospital is
the eighth largest in the country.

We have seen over 6,000 pediatric patients in the past 16 years, including almost
4,000 from the state of Missouri and 2,000 from the state of Illinois. The program
has two new and follow-up patient clinics on Mondays and Thursdays at SSM Health Cardinal
Glennon Children’s Hospital and pediatric patients are also seen daily at the Saint
Louis University Doctors Office Building and Des Peres Hospital.

Research

The Pediatric fellowship program also has an active research program involving studies
of juvenile arthritis and systemic lupus with over 200 publications and 200 presentations
over the last 20 years being presented on these topics. Research grants funded by
the National Institutes of Health (NIH) have been obtained for studies in juvenile
arthritis and multiple studies have been performed in patients with childhood systemic
lupus and other connective tissue diseases.

Research projects continue with studies on rheumatoid factor and anti-CCP antibodies
and their isotopes and different epitopes. Studies continue on systemic lupus patients
looking at regulatory T cells and cellular function and this is funded until 2017
by an R01 grant from the NIH. The program is accredited for two positions.

Curriculum

Didactics

We have a strong didactic curriculum and our faculty are enthusiastic teachers. We
aim to improve and innovate our educational curriculum each year.

This conference is held on a weekly basis throughout the year and focuses on the basic
core knowledge of clinical manifestations, clinical presentations, pathophysiology
and management of rheumatologic diseases or systemic diseases with rheumatic manifestations.
Topics such as pharmacology, exercise and sports related injuries, physical medicine
and neurology are also included. Also, during this conference, each fellow will present
an evidence-based review on the topic of their choice twice yearly.

This conference is held jointly with attending physicians, fellows and residents from
the division of radiology and division of rheumatology on a monthly basis. Rheumatology
fellows and attendings select cases for presentation and review. Emphasis is placed
on integrating clinical presentation and radiographic findings.

This conference occurs on a monthly to every other month basis and includes didactics
focusing on cellular elements of the immune system, inflammatory mechanisms, immune
responses, immunomodulation and immunoregulation.

Clinical case conferences are held weekly. Rheumatology fellows, rotating rheumatology
residents and attendings rotate and present a complex clinical case with group discussion
of the differential diagnoses followed by an evidence-based review of the literature
and question and answer. Incorporated in the clinical case conferences will be cases
presented by each fellow with emphasis on Morbidity and Mortality as it pertains to
rheumatic disease.

Journal Club will occur on a monthly basis and will involve the attendings and fellows
presenting a pertinent article of original research on a rotating basis. A subsequent
discussion and critique of the methodology and results are included.

This conference is held on a monthly basis on average. Faculty in rheumatology or
faculty in other disciplines performing research relevant to rheumatology will present
and discuss their ongoing research. In addition, discussion of topics pertinent to
clinical and bench research will occur.

A separate board review didactic supervised by Katherine Temprano, M.D., will occur
at least bimonthly with all fellows that will include textbook chapter discussion
(using Hochberg as the main educational text) in conjunction with the American College
of Rheumatology (ACR) Image Bank, and other board review material.